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Brief Title: Gemcitabine and ON 01910.Na in Previously Untreated Metastatic Pancreatic Cancer
Official Title: A Phase III, Multi-center, Randomized, Controlled Study to Compare the Efficacy and Safety of Gemcitabine Alone vs. ON 01910.Na Combined With Gemcitabine in Patients With Previously Untreated Metastatic Pancreatic Cancer
Study ID: NCT01360853
Brief Summary: The question being asked in this study is: Will patients with advanced pancreatic cancer live significantly longer if they are treated with a combination of Gemcitabine and ON 01910.Na than if they are treated with Gemcitabine alone? There are two parts to this study. In the first part of the study, patients with metastatic pancreatic cancer who have received no prior chemotherapy for this disease will be assigned by chance either to the group that will be treated with both Gemcitabine and ON 01910.Na (about 100 patients will be in this group) or, to the group that will be treated with Gemcitabine only (about 50 patients will be in this group). How long patients survive in the 2 groups will be compared. If it looks like there is no difference between the groups, the study will stop. If it looks like patients in the group that were treated with both Gemcitabine and ON 01910.Na survive longer, the study will continue into a second part where more patients will be treated in order to confirm and better understand the findings of the first part of the study.
Detailed Description: This will be a Phase III study with sample size recalculation after 100 events have occurred. The study will be open-label, randomized, controlled, multi-center and will be conducted at approximately 200 to 300 study sites (60 to 80 study sites in the first portion of the trial). In the first portion of the study, a total of 150 patients with metastatic pancreatic cancer who have received no prior chemotherapy for this disease will be randomized in a 2:1 fashion to 1 of the 2 following treatment regimens: * Arm A: Gemcitabine 1000 mg/m2 weekly for 3 weeks of a 4 week cycle + ON 01910.Na 1800 mg/m2 via 2 hr continuous intravenous infusion (CIV) infusions administered twice weekly for 3 weeks of a 4 week cycle (approximately 100 patients) * Arm B: Gemcitabine only, 1000 mg/m2 weekly for 3 weeks of a 4 week cycle (approximately 50 patients). Patients will be stratified at entry using the Eastern Cooperative Oncology Group (ECOG) performance status (ECOG scores of 0 1 vs. ECOG scores of 2; patients with higher scores will not be enrolled). Patients will remain on study until disease progression or death from any cause, whichever comes first. Moreover, after treatment discontinuation for any cause, all patients will be followed until death. After 150 patients have been enrolled, accrual will pause and patients will be followed until 100 deaths have occurred. At that time, the Data Safety Monitoring Committee (DSMC) will oversee a formal interim analysis to compare overall survival (OS) between the 2 groups and may recommend early stopping for futility. If the study continues after interim analysis, then the randomization scheme will continue up to 364 patients or the newly-calculated sample size. The maximum number of enrolled patients will be 650. The number of clinical sites may be expanded up to approximately 200 to 300 centers. Patients in the gemcitabine-only arm (Arm B) will not be allowed to cross over to the combined treatment arm (Arm A). In addition, no palliative radiotherapy will be allowed during the trial. The primary analysis will compare OS in the ON 01910.Na + gemcitabine arm (Arm A) vs. gemcitabine-only arm (Arm B) once an appropriate number of events has been reached. There are 2 secondary efficacy outcomes: progression-free survival (PFS) and objective response. Toxicity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events v4.03. Grade 3 and 4 hematologic toxicities and \> Grade 2 non-hematologic toxicities will be monitored.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
UCSD Moores Cancer Center, La Jolla, California, United States
Desert Comprehensive Cancer Center, Palm Springs, California, United States
Pacific Cancer Care, Salinas, California, United States
Premiere Oncology, Santa Monica, California, United States
University of Colorado Cancer Center, Aurora, Colorado, United States
Kaiser Permanente Colorado, Denver, Colorado, United States
Poudre Valley Cancer Center of the Rockies, Fort Collins, Colorado, United States
Yale Cancer Center, New Haven, Connecticut, United States
Mount Sinai Comprehensive Cancer Center, Miami Beach, Florida, United States
University of Hawaii Cancer Center, Honolulu, Hawaii, United States
University of Kansas Cancer Center, Westwood, Kansas, United States
UMASS Medical School, Worcester, Massachusetts, United States
Karmanos Cancer Institute, Detroit, Michigan, United States
Billings Clinic Cancer Center, Billings, Montana, United States
Roswell Park Cancer Institute, Buffalo, New York, United States
New York University Langone Medical Center, New York, New York, United States
University of Rochester Medical Center, Rochester, New York, United States
University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, United States
Levine Cancer Institute, Charlotte, North Carolina, United States
Cone Health Cancer Center, Greensboro, North Carolina, United States
Hendersonville Hematology and Oncology at Pardee, Hendersonville, North Carolina, United States
Rex Cancer Center UNC Healthcare, Raleigh, North Carolina, United States
St. Alexis Medical Center-Mid Dakota Clinic PC, Bismarck, North Dakota, United States
University of Cincinnati Cancer Center, Cincinnati, Ohio, United States
Kaiser Permanente NW, Portland, Oregon, United States
Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States
Medical University of South Carolina - Hollings Cancer Center, Charleston, South Carolina, United States
McLeod Regional Medical Center, Florence, South Carolina, United States
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, United States
Seattle Cancer Care Alliance, Seattle, Washington, United States
Semmelweis University Department of Diagnostic Radiology and Oncotherapy, Budapest, , Hungary
Semmelweis University, 3rd Department of Internal Medicine, Budapest, , Hungary
Hetenyi Geza Hospital 5004, Szolnok, Hungary, Szolnok, , Hungary
Basavatarakam Indo-American Cancer Hospital, Hyderabad, Andhra Pradesh, India
Regional Cancer Center, Thiruvananthapuram, Kerala, India
Jaslok Hospital & Research Centre, Mumbai, Maharashtra, India
Shatabdi Superspeciality Hospital, Nashik, Maharashtra, India
Ruby Hall Clinic, Pune, Maharashtra, India
Lifeline Multispeciality Hospitals, Chennai, Tamil Nadu, India
State Budget Medical Institution of the Arkhangelsk Region, Arkhangelsk, , Russian Federation
Chelyabinsk Regional Clinical Oncology Center, Chelyabinsk, , Russian Federation
State Budget Medical Institution Clinical Oncology Center 1, Krasnodar, , Russian Federation
Budget Medical Institution of the Omsk Region: Clinical Oncology Center, Omsk, , Russian Federation
State Budget Medical Institution: Leningrad Regional Clinical Hospital, Saint Petersburg, , Russian Federation
State Medical Institution: Tula Regional Oncology Center, Tula, , Russian Federation
Zakarpattia Regional Clinical Oncology Center Department of Chemotherapy, Uzhhorod, , Ukraine
Name: Wells Messersmith, MD
Affiliation: Anschutz Cancer Pavilion
Role: STUDY_CHAIR
Name: Lawrence P. Leichman, MD
Affiliation: Academic Oncology Gastrointestinal Cancer Consortium
Role: STUDY_CHAIR
Name: Antonio Jimeno, MD, PhD
Affiliation: Anschutz Cancer Pavilion
Role: STUDY_CHAIR